8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 1/14

6/6/201

Female Reproductive System

Histology

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 2/14

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 3/14

6/6/201

Vagina• Fibromuscular tube: vestibule → uterus• Four layers:

– Stratified squamous epithelial mucosa rich inl co en

– Lamina propria: rich in elastic fibers and thin-walled blood vessels (veins, venules)

– Fibromuscular layer: ill-defined inner circularand outer longitudinal smooth mucles.

– Adventitia: fibrocollagenous tissue withnumerous thick elastic fibers, large blood vesselsand ganglion cells. Also, deeply some skeletalmucles: around introitus

• Rich meshwork of elastic fibers: responsiblefor elongation during parturition. Vessels:

watery vaginal fluids.• Shallow longitudinal midline grooves onanterior and posterior vaginal walls, andtransverse mucosal folds

Vagina• Changes occur in non-keratinized stratified squamous

epithelium• Before puberty and after menopause: thin epithelium• During reproductive years: under estrogen influence →

thickening. Basal cells and a distinct parabasal layer → ↑ mitotic activity. Superficial cells → ↑ number and sizedue to glycogen and lipid storage. Glycogen content ismaximal at time of ovulation

• Breakdown of glycogen by lactobacilli → lactic acid →

acid pH• Bartholin Glands: acini lined by tall columnar mucus-

secreting cells with pale cytoplasm and small basalnuclei. Their ducts are lined by a transitional epitheliumwith a surface mucin-secreting layer

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 4/14

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 5/14

6/6/201

Cervix in Parturition• In the glycosaminoglycan matrix hyaluronic acid

concentrations between collagen fibers increases →

fibers in cervical stroma → softness of cervix.• Dermatan sulfate concentration ↓ → weakening of

dermatan sulfate bridges holding adjacent collagen andelastin fibers together.

• Changes in collagen and elastin fibers: Type I and II,

their strong parallel alignment and become shorter.• All this lead to a reduction in tensile strength and a ↓ in

resistance to the presenting part of the fetus• Similar changes occur in elastin fibers

Ectocervix• Covered by epithelium like the

one in va ina: non-keratinizin ,stratified, squamous, rich inglycogen.

• It undergoes cyclical changesduring the menstrual cycle:influence of E and P

•age: epithelium much thinner and smaller

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 6/14

6/6/201

Edocervical Canal

• The canal is lined by

columnar mucus-secreting epithelium

Endocervical Canal

• Deep slit-like invagination of thesurface epithelium with blind-ended tubules arising from thecleft.

• So large surface area for production of mucin.

• Role in vaginal lubrification andas a barrier

• Movement of mucus by ciliatedcolumnar endocervical epithelialcells mostly close to internal os

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 7/14

6/6/201

Squamo-Columnar Junction• Most likely place of disease• Usually located in the region of

ex erna os, an n uence ymaternal hormone production in-utero

• At puberty: E → extension of columnar epith. onto ectocervix→ ectropion or cervical erosion→ pregnancy and may bleed)

• Before puberty pH is alkaline.• After puberty due to glycogen

breakage → pH acidic ( ≈ 5-3)

Squamo-Columnar Junction• Exposition of sensitive columnar

e ith. to acid H → s uamous.metaplasia and a transformationzone between endocervicalcolumnar epithelium andectocervical squamous one

• This TZ could be variable in size.•

the endocervical canal, withsometimes clinical consequences(e.g. in colposcopy)

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 8/14

6/6/201

Squamo-Columnar Junction

• TZ forms as squamous epith.regrows over ectropion:metaplasia.

• Openings of some glands willbe blocked → mucin producedwill accumulate to form cysts:Nabothian cysts.

• Also, under (mis)appropriate,

correction may lead to

dysplasia that may lead tocarcinoma

Cervical mucus• Secreted by endocervical

e ithelium which shows little microscopical changes thruout the cycle, althoughultrastuctural one were noted

• Physical (rheological) andchemical (ionic composition)

ro erties chan e durin cycles according to hormonal(estrogenic or progestational)milieu

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 9/14

6/6/201

Cervical mucus

• During follicular phase: mucin is, ,

alkaline pH• Composed of network of

glycoprotein micelles: insidespaces occupied by plasma richin Na, K and Cl ions.

•pattern seen when dried

Ferning

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 10/14

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 11/14

6/6/201

Uterine Body

• Thick walls of smooth muscles: myometrium• M ometrium is hormone-sensitive: h er-

trophy and hyperplasia (pregnancy)• Endometrium: lining of uterine cavity. Also

hormone-dependant and cyclical changes• Before puberty: simple low cuboidal epith.

supported by scanty spindle-celled stroma• Reproductive years: 2 layers: deep basal at

contact with m ometrium reserve and superficial functional (cyclical). Around tubalostia and internal os: less sensitive to E+P

• After menopause: reversal to prepubertalaspect

Uterine Tubes

• 10-12 cm, 4 parts: infundibulum, ampulla, isthmus, interstitial• Each differ histolo icall : ro ortion of muscle/e ithelium and ,

degree of convolution of epithelium• Muscular tube lined by specialized epithelium variably folded and

plicated

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 12/14

6/6/201

Uterine TubeAmpulla

Uterine TubeIsthmus

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 13/14

6/6/201

Ovary

• Hilum, medulla and cortex• Surface layer: cuboidal,

continuous with pelvicperitoneum at hilum. Prominentmicrovilli, occasional cilia;mitochondria abundant and smallpinocytotic cells.

• Fissures lined by epithelium.This may seal and accumulatedsecretions → germinal inclusioncys s

• Tunica albuginea separates

surface cells from underlyingovarian tissue.

Ovary

• Hilum: blood vessels, lymphatics

• Histologically identical to Leydigcells: round or oval, eosinophilicgranular or foamy cytoplasm withlipofuscin pigm. May containReineke’s cristalloids

• Medulla: cluster of stromal cells.• Hilum and Medulla may also

conta n vest g a remnants oWolffian ducts• Cortex: supporting stroma and

gamete-producing structures

8/6/2019 Histology-Female Compatibility Mode

http://slidepdf.com/reader/full/histology-female-compatibility-mode 14/14

6/6/201

OvaryCortical Stroma

• - - • Cytoplasm rich in ribosomes and microfilaments• Numerous mitochondria around nucleus.• Micropinocytotic vesicles and lipid droplets• Reticulin and collagen fibers: outer part of cortex• Progressive collagenization: puberty → menopause• Cellularity and amount of lipid depends on hormones: ↑

in lipid (under P influence) is called luteinization

OvaryCortical Stroma

• Three main functions : – suppor s ova, – generates theca interna and externa, – secretes steroid hormones: 3 types of stroma

cells• Theca cells: interna and externa (around the

follicle)• Scattered lipid-rich luteinized stromal cells• EASC (oxidative and enzyme activity): ↑ in

menopause (might secrete testosterone)